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General NPI Number Information
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NPI Number | 1952593873
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Entity Type | Organization
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Legal Business Name | FAMILY PRACTICE ASSOCIATES PC
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Dates
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Enumeration Date | 08/14/2007
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Last Update Date | 03/06/2020
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Provider Practice Location Address
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Address Line | 433 SUMMIT BLVD UNIT 201
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City | BROOMFIELD
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State | CO
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Zip | 80021-8299
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Country | US
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Telephone | 303-673-9090
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Fax | 303-673-9195
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Provider Business Mailing Address
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Address Line | 433 SUMMIT BLVD UNIT 201
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City | BROOMFIELD
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State | CO
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Zip | 80021-8299
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Country | US
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Telephone | 303-673-9090
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Fax | 303-673-9195
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | ANGIE MARTIN
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Credential |
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Telephone | 303-673-9090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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